application form

Transcription

application form
Phone:
C.V.RAMAN RESIDENTiAL
Affix recent
PU COLLEGE OF SCIENCE FOR BOYS & GIRLS,BIDAR
passport size
8792549081, 8792549082, 8792549083, 8792549084
colour
photograph
Pre University Application Form
(PU Education Board Karnataka)
Application No:
For Office use only:
Admission No:
NOTE: Please tick only one combination of your choice & fill up the application form in Block Letters
SCIENCE
PCMB
PCME
PERSONAL INFORMATION
Name of Applicant
………………………………………………………………………………
(As per school records)
…………………………………………………………………………………………
Nationality: …………………….
Religion: ……………………
Caste: ………………….
Date of Birth:
MM
DD
YY
Place of Birth: ……………………….
Please tick the relative group (enclose the recent caste and income certificates)
General
Category 2B
SC
Category 3A
Name of Father:
Address:
PIN:
Name of Mother:
Address:
ST
Category 1
Category 3B
Category 2A
Physically Challenged
Occupation:
Office Address:
Phone:
PIN:
Phone:
Total annual income:
PIN:
Occupation:
Office Address:
Phone:
PIN:
Phone
Name of the Guardian:
Occupation:
Local Residential Address: ……………………………………………………………………………………….......
……………………………………………………………………………………………………………………………………….
Pin:
Phone:
Mobile:
Email:
Pre University Application Form
POSTAL ADDRESS (Permanent Address)
LOCAL ADDRESS (Communication)
ACADEMIC INFORMATION
Full Address of the Institution last Attended: ……………………………………………………………
………………………………………………………………………………………………………………………………….
Percentage of marks obtained in SSLC:
(Enclose attested copy of marks card)
Board of examination:
SSLC
ICSE
CBSE
Others: …………………………………………………
Month & Year: …………………………………..
Reg No: ……………………………
RESULT OF CLASS X (Final if not available fill in the Last Terminal Result)
SUBJECTS
MAX.MARKS
LANGUAGE 1
LANGUAGE 2
LANGUAGE 3
OPTIONAL SUBJECT 1
OPTIONAL SUBJECT 2
OPTIONAL SUBJECT 3
OPTIONAL SUBJECT 4
OPTIONAL SUBJECT 5
TOTAL MARKS
Aggregate Percentage
MARKS OBTAINED
CLASS/DIVISION
Pre University Application Form
RESULT OF CLASS IX
SUBJECTS
MAX.MARKS
MARKS OBTAINED
CLASS/DIVITION
LANGUAGE 1
LANGUAGE 2
LANGUAGE 3
OPTIONAL SUBJECT 1
OPTIONAL SUBJECT 2
OPTIONAL SUBJECT 3
OPTIONAL SUBJECT 4
OPTIONAL SUBJECT 5
TOTAL MARKS
Aggregate Percentage
College you have applied to:
1.…………………………………………………………………………………………………………………………………
2.…………………………………………………………………………………………………………………………………
3.…………………………………………………………………………………………………………………………………
Extracurricular Activities:
ORDERS OF THE PRINCIPAL
Admit to: I Year …………………………………………………………………………………………………………..
Language: English & ……………………………………………………………………………………………………
Signature of the Principal
REMARKS
OFFICE NOTE
Fees Rs:
Receipt No:
Date:
Dues:
Original Documents required for
approval from PU Board
Original Mark Sheet:
Transfer Certificate:
Migration Certificate:
Others:
Pre University Application Form
REGULATIONS FOR ADMISSION
The course consists of 2 parts: Part-1 Languages & Part-2 Core Subjects.
Languages offered under part I in the college English (Common to all) and other
languages –Kannada & Hindi (Optional).
Certified photocopy of Statement of Marks is required to be enclosed with the
application at the time of submission.
All reservation category candidates have to submit caste and income certificates.
Admission is made only after a personal interview with the Principal and
Management.
Candidates should produce the original Marks Card. Transfer Certificate and four
recent passport size photographs at the time of admission.
Candidates from other boards (like ICSE, CBSE, etc.) apart from Karnataka SSLC.
Should enclose copies of Migration Certificate along with their Marks Card and
Transfer Certificate.
Payment of prescribed admission fee should be made on or before the date
notified in the college, failing which the admission shall stand forfeited.
Admission is provisional, subject to ratification by the Pre-university Board.
A minimum attendance of 75% in each subject is compulsory. Please note that
students who do not have adequate attendance will not be permitted to appear
for the final examination.
Parents/guardians are requested to meet the Principal/ teachers concerned to
ascertain the attendance and progress of their wards at least once a month.
Any act of misconduct, indiscipline, vandalism or damage caused to the college
property, laboratory equipment, sports materials, library books, reference
volumes, journals and periodicals, defacing of furniture and walls, etc shall be
seriously viewed and are punishable with penalty and the decision of the Principal
shall be final in this matter.
The tests and examinations conducted by the college are mandatory.
Participation in extra-curricular activities is voluntary but desirable.
Group Prayer as per the schedule, is compulsory for all students.
Use of mobile phones and other electronic gadgetries inside the college campus is
prohibited.
Students should strictly adhere to the dress code specified by the college.
Neatness and dignity in dress should be strictly observed.
If any dress is found objectionable any member of the staff can take immediate
action on the student.
Visitors are permitted only with prior appointment of the concerned authority
and as per the schedule.
All proceedings shall be under the jurisdiction of Karnataka.
DECLARATION
I have read the rules and regulation specified for admission to institution and will strictly adhere to
the same. I promise to abide by the decisions taken by the authorities. I understand that amount
once paid towards admission is non-refundable.
Signature of the Parent/ Guardian & Date
Signature of the candidate